WHAT IS THE ORAL MICROBIOME & HOW DO YOU LOOK AFTER IT?



A look at the oral microbiome and why it is important for our overall health


a-healthy-mouth-and-teeth
A healthy mouth can mean a healthy body!

What actually is the oral microbiome?


You have probably heard a huge amount about the gut microbiome this year, it has become one of the most talked about subjects and there is a huge amount of exciting research going on to discover exactly what part it may play in certain illnesses and how it can affect our moods and even cause anxiety and depression.




What about the oral microbiome though? This area of health has not been covered as widely but our mouth is a gateway to the rest of the body. Inside the mouth there is a living world of bacteria working away to try and keep the mouth, gums and teeth healthy. It gets a lot of abuse with smoking, vaping, food, alcohol, hot drinks and even mouthwash, many of which also contain alcohol. All these things can disrupt the balance of good bacteria/bad bacteria (the oral microbiome) in the mouth and weaken our oral defences, possibly leading to bad breath, sore patches or gum disease. As we get older the mouth can also become a lot drier causing problems for some people and medical treatments such as chemotherapy can cause their own issues with the mouth such as sensitivity and ulcers.



An unhealthy mouth can cause problems in the body


A lot of people are unaware that disease in the mouth can affect other parts of the body too.


"The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only 1 in 6 people realises that people with gum disease may have an increased risk of stroke or diabetes. And only 1 in 3 is aware of the heart disease link." - Dr Nigel Carter, Chief Executive - British Dental Foundation


Gum disease is usually caused by bacteria from the build up of plaque on the teeth. In cases of extreme inflammation it is believed that it can also affect the bloodstream and slowly damage blood vessels in the heart and brain over a period of time.


In your mouth a mixture of bacteria, proteins and saliva cover your teeth in a very thin layer most of the time. Small particles of sugars and acids from the food and drink you consume will stick to this film and over time it will build up into what is known as plaque. It is the bacteria that live on the plaque that can cause gum disease but of course brushing your teeth and flossing or using interdental sticks will help remove the plaque and help prevent the build up.



Encourage the good bacteria in your mouth by using a gentle toothpaste


It make sense to look after the oral microbiome and encourage the good bacteria that live there. You can help with this by not consuming too much sugary food and drink, not smoking or vaping and not using a mouthwash that contains alcohol. You can also help the oral microbiome by using a gentle toothpaste without harsh cleaning ingredients which will also encourage an environment where the good bacteria can flourish.


I have spent quite a bit of time looking at toothpaste. When I had chemotherapy it gave me the most dreadfully sore mouth. I literally had so many mouth ulcers that I could barely put water in it because the pain was unbearable. At the time I changed from a standard toothpaste, which caused great discomfort, to a natural one which did help. Most standard toothpaste contains some quite harsh cleaning agents such as SLS or antibacterial and antifungal agents such as tricolsan (see my blog post What is Clean Beauty Part II - 15 ingredients to try and avoid in your skincare and makeup) which can strip the delicate areas in the mouth, killing your good bacteria and making you more prone to soreness and ulcers, and in theory also gum disease.


The trouble with a lot of natural toothpaste is that it does not contain any fluoride. I know there are many arguments out there for avoiding fluoride (which is a naturally occurring mineral) but it does help protect the enamel on the teeth and help prevent tooth decay. The issues with fluoride come from over-consumption orally and as I am not swallowing the toothpaste (which is why children should always be supervised when they brush their teeth) and rinse my mouth out thoroughly after brushing I am not overly worried about having fluoride in my toothpaste. I like to ring the changes though and frequently alternate between a natural non fluoride toothpaste and a gentle, more natural formulation toothpaste with fluoride.



A natural toothpaste with no fluoride



Aloe-Dent-triple-action-charcoal-toothpaste
a natural toothpaste with a strong mint kick!

The toothpaste that I use when I want to brush with a completely natural product is the Aloe Dent aloe vera triple action charcoal toothpaste - it's way better than it sounds! It looks a bit odd as it is a black toothpaste but it has a good whitening effect on the teeth due to the addition of the silica, activated charcoal and Icelandic moss. I was somewhat sceptical about the whitening but have to say that it works really well. The toothpaste is completely free from SLS and tricolsan and is mild on the delicate areas of the mouth but also has a strong mint flavour for those people who often find that a natural toothpaste can be a bit bland and miss the 'hit' they get from a conventional toothpaste or want an extra 'fresh breath' feel.



Ingredients: glycerin, aloe barbadensis leaf juice, sorbitol, hydrated silica, aqua, sodium lauroyl sarcosinate, mentha piperita (peppermint) oil, cetaria islandica (Icelandic moss) extract, hydroxyethycellulose, menthol, xyitol, stevia rebaudiana (stevia)extract, melaleuca alternifolia (tea tree) leaf oil, escin, phenoxyethanol, sodium benzoate, potassium sorbate, citric acid, charcoal powder (activated), benzyl alcohol (not derived from ethanol), limonene (natural constituent of essential oils).


The aloe vera helps soothe the gums, the tea tree oil acts as a natural antiseptic, the silica and Icelandic moss are for whitening, the stevia is a natural sweetener, the escin (derived from horse chestnut) is for healthy gums, the activated charcoal naturally whitens and removes impurities and the menthol is there for natural flavour. Aloe Dent do a variety of toothpaste options such as sensitive, whitening fluoride free, whitening with fluoride, children's, and Miswak (aloe vera). Aloe Dent triple action charcoal toothpaste is suitable for vegetarians and vegans and a 100ml tube costs £4.59.



A more natural, gentle toothpaste with fluoride


I was also keen to try a gentle toothpaste with fluoride. Dentists recommend that a toothpaste has at least 1450ppm of fluoride or it won't be good enough to protect the teeth. I came across a toothpaste called Zendium that has been developed without SLS and tricolsan but with natural enzymes and proteins. As an additional benefit it claims to boost the good bacteria in the mouth whilst reducing the bad bacteria (dental plaque data on bacterial species showing significant change in a 14 week clinical study with 102 subjects). The company claim that it will help strengthen the natural defences in the mouth and work with the body boosting the naturally protective bacteria without the need for harsh or aggressive ingredients, giving a more balanced oral microbiome in 14 weeks. It is also 4 x gentler on the mouth than a standard toothpaste and has the required 1450ppm of fluoride.



Zendium-gentle-whitening-toothpaste
an SLS and triclosan free toothpaste but with fluoride

I have been using Zendium gentle whitening toothpaste for quite a while now and am impressed with it. Some people do not appear to have any problems with standard toothpaste but I don't like the slightly burning feeling that some toothpastes have. Zendium works and tastes just like any other toothpaste I have used. My mouth feels clean and fresh and it appears to get rid of the plaque build up. The skin on my cheeks is more 'slippy' and soft (as it should be) and there is no burning feeling afterwards. It is a white toothpaste and has a mild mint taste, it is quite subtle but my mouth feels fresh after using it. The whitening level is good too, coping with my strong coffee and tea habit!




Ingredients: aqua, hydrated silica, sorbitol, glycerin, steareth-30, disodium pyrophosphate, disodium phosphate, xanthan gum, aroma, carrageenan, sodium fluoride, sodium benzoate, amyloglucosidase, zinc gluconate, sodium saccharin, glucose oxidase, potassium thiocynate, lysozyme, colostrum, lactoferrin, lactoperoxidase, citric acid, CI 77891


Zendium hits the spot for being more natural and less harsh than a standard toothpaste but still having the protection of fluoride. It does contain egg and milk proteins so would not be suitable for vegans. Zendium do a full range of toothpastes such as complete protection, sensitive, gentle whitening, kids 1 - 6 for milk teeth and junior 7+ so there should be one suitable for all members of the family. Zendium Natural Whitening costs £4.80 for 75ml.


I use both of these products and am very happy with their performance, particularly the whitening and the fact that they do not give me any sensitivity in my teeth (which some whitening toothpastes can do).


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